DHHS Reviewing 5,805 Medicaid Prenatal Cases

Lincoln - Letters sent Feb. 4 to 5,805 pregnant women receiving Medicaid coverage were not sent in error and should not be ignored, said Kerry Winterer, CEO of the Nebraska Department of Health and Human Services (DHHS).

The letters notified women that Medicaid eligibility of their unborn will end March 1 because the unborn is not an accepted federal Medicaid eligibility category.

The letter also said their cases would be reviewed by caseworkers during February to determine if the pregnant women are eligible in their own right.

As of today, nearly half of the 5,805 cases have been reviewed.

Women who are in the country illegally will not be eligible for Medicaid coverage; previously, their unborn were determined eligible because children who are born in the U.S. are U.S. citizens.

Based on the reviews thus far, it appears that most of the other women will be eligible in their own right.

“We understand the benefits and value of prenatal care,” said Winterer. “Caseworkers are diligently reviewing the cases because of the critical nature of this issue.”

Reviews began last week with caseworkers being told not to include the unborn in the family size. The federal Centers for Medicare and Medicaid Services clarified that the unborn can be counted in the family size. At that time about 65 cases statewide had already been reviewed. They were reviewed again using the latest guidance and if eligibility changed, those women are being notified.

“These 65 cases are at the center of recent news reports,” said Winterer. “While relatively few case reviews were affected, we regret that some of these women received notifications that were incorrect.”

He said recent news stories suggesting that women ignore letters about this issue are unfortunate and misleading.

“Women do not need to contact DHHS about these cases. All 5,805 cases should be reviewed before the end of the month,” he said.